Leading and Influencing with Impact

I'd like to share a little bit about institute for leadership effectiveness and why we exist and mark and i are going to talk to you today about maybe a rethink or a way of thinking of leadership in an entirely different way especially as we've been involved in so many different dynamics and changes occurring being with the institute for leadership effectiveness our real vision and our purpose in our organizations is to build and foster this organization-wide leadership development function that both grows and nurtures highly effective leaders and creates teams or fosters teams in alignment with serving the people in our community whether that be patients students physicians non-physicians and leaders so today we want to focus specifically on leadership in the context of this thing that we call health systems science and as we as i think about health system sciences in the context of the leadership one of the things that we know for sure is that there is the there's the basic science if you will of health system science which is learning about all these interrelated parts to this ecology of healthcare delivery and then there's the actual clinical part of this which is how does it play out in our world and what we know is that just like in the clinical training that we go through as as as clinicians we have kind of the basic sciences and then we have the clinical sciences we also want to think about that in the context of this health system science and leadership because where leadership comes in is not around the theory leadership comes in in terms of the actual delivery of health care and so what jennifer and i want to do today is to begin to think about how leadership fits into this by introducing you to a specific structure or a specific approach to leadership that's called regenerative leadership and jennifer i'll share a little bit more about that in a moment but what we want to say about leadership is today taste of what leadership might look like in the context of beginning to think about health care as a true system we call what we do now being part of the health care system but the fact is that there's been nothing systematic often about the design of health care as it's presently delivered it's really jerry-rigged from a bunch of component parts and and we believe that the actual science of looking at the delivery of health care is going to evolve that over the next hopefully few years not waiting too long and leadership will be a crucial part of that and so today we're going to not only introduce you to this whole idea of regenerative leadership but more specifically we want to give you a taste of it by actually having you start to process a little bit and reflect a little bit on leadership you know when we think about what this what a living system really is and what we're referencing is how we mimic what's going on in nature so if we think about life and what you're seeing in this slide is how everything is so interconnected whether it be how we lead how we influence how we work and how we live so if you think about it from a design perspective we have an opportunity to design our work and our world and our life in this method of bio bioinnovation biomimicry and regenerate the way in which we function and lead we also see this in our organizational cultures so this is where when looking at a living system or applying this and living systems we want to understand that we're we have gone through this industrial revolution in fact whenever i was in business school in undergrad and in graduate school everything was looked at kind of as a as a machine or organizations as machines organizations or people as machines and we have this grand opportunity to to shift the way we think of organizations as living systems and how we shape our culture the space where we work how we interact with each other how we get work done and shifting the dynamic and looking at living systems and moving that forward and then ultimately how our being is how we as individuals integrate into this living system both in work and in life and do so in an effective way both for ourselves and for our people that we work with going forward so we want to introduce some of the specifics because it can sound a bit abstract or a little high level so let's bring it down a little bit more in detail so we think about our living systems as being life affirming so when we say life affirming what we're being meaning as an overarching is that the things that we do in work and in life that they are focused on building others up or producing life we see this in nature that our processes interconnect in order to to affirm life we also think about how nature is ever changing and responsive so a bird does not simply stay stagnant whenever there's change in its environment it migrates or it integrates and so we know that change is going to happen how do we then respond to change and integrate change versus pushing against following this method of nature we also see that everything is interconnected we talked about this in the previous slide but how our environment is collaborative with each other if we think about a coral reef as an example what we might see is that interconnectivity of the nutrients and people working together or in that coral reef environment the organisms working together to inform the biosystem we also know that not only are uh that our systems center synergistic but they need to be synergistic because of their diversity and certainly diversity is something that is talked a lot about and yet the management of diversity in a way that brings out the best in in the different diversity within a system is essential because we also know that sometimes diversity causes dynamic tension and the ability to to manage that dynamic tension is essential in any kind of system starting with an ecology but then advancing on to this whole idea of health system science also know something from nature that we don't often follow within the world of health care and that is this whole idea of cyclical and seasonal nature to things we often don't follow this very well certainly in my own profession as a physician uh acknowledging that there there are ebbs and flows even to our energy and how do we make sure that we're really acknowledging that just on a on a micro level but also on a macro level within this within the sense of an organization there are going to be seasons there are going to be cycles we know there are economic cycles and how do we begin to much more consciously and deliberately bring those factors into our leadership as we think about the delivery of health care as i said we also know that there are flows of energy and this isn't just energy in terms of ebbs and flows but also their flows of energy between different systems we know that there are flows of energy that can help uh advance a particular group and that flow of energy can be in terms of first of all resources but it can also be in terms of of human resources it can be in terms of ideas those are all things that allow systems to begin to interrelate in a very different way and so recognizing how those flows of energy happen and doing those very deliberately becomes essential as we think about this idea of how do we begin to think about healthcare truly as a system and then this whole idea of living systems field so we know that in nature there is some kind of field upon which all of this happens things happen and occur in nature that there doesn't seem to be any particular explanation for and yet they happen regularly and that's the the theory of that is the underlying field theory of understanding whether that be in quantum physics whether that be in biological systems that there's something that is underlying all those structures not in a way of being mystical per se but just as a way of acknowledging that that what connects all this together is often something that we know occurs but it's still uncertain for us it's still a little bit mysterious for us and so as a leader beginning to think about how does that actually look in terms of our living system that we call healthcare is going to become an essential quality of this this approach that we call regenerative leadership and so we want to go ahead and start that process by thinking about this whole term regenerative so as jennifer said earlier regenerative is about reframing revitalizing um reusing resourcing but in order to do that there's this prefix on that word and that is re re in the latin prefix means to do again or again and again and so in order to be regenerative there has to be something generative going on in the first place and so here's what we'd like to do for our first breakout session to start to get you thinking a little bit about this in a very concrete and very much tangible way which is thinking about first of all a leader and we're asking that you don't name this leader as you go into your breakout rooms but think about a leader who brought out the best in you through their leadership and what we're interested in is not who this leader was but the characteristics that they displayed and the manner in which they went about doing that that allowed that best to be drawn from you because what we do know we know this from from many of the sciences including the the sociology sciences that people don't always bring their best to work we have this phenomenon called presenteeism and that's certainly been a big issue during covid so what is it about certain systems that allow the best to be brought out in us and then and then we're not going to explore the others because the others are often the opposite of that so thinking about a leader who brought out the best in you what were the qualities that they did so that's discussion number one discussion should there be time is thinking about the same thing now on a systems level thinking about a team that you were proud of traditionally you might think about that as a work team could be a sports team could be a musical group you were part of could be a drama group that you were part of anything that you would consider a team that performed at a high level and once again you don't have to name what that team was but what were the characteristics that allowed that team what was going on the the whole dynamics that allowed that team to perform from your opinion at such a high level so thinking about that as a leader first of all the qualities and then the team the qualities we're gonna split you into groups of four and we're going to have you four or five and we're going to have you for the next 12 minutes uh just go ahead and we ask that you come on screen for your your small groups and you're going to explore those things together and then we're going to come back and debrief that a little bit so we'll see you in 12 minutes hey welcome back everyone i'm actually going to stop screen share so we can do some some debrief discussion and then we'll have some more dialogue it'll be nice to see each other since i'm gonna have camera on so was it did you see some people that you hadn't seen in a while and um could share some insights about these leadership qualities that have been effective for you what are some of those qualities someone would mind sharing we talked about directness and um the ability to kind of identify people's strengths and weaknesses and assign them to appropriate roles to make the best of their their time and energy yeah so fostering that greater amount of directness and impact thank you what other qualities did you discuss that mimic or um embody some of these characteristics that we've been discussing we also talked about just leaders um being ones that genuinely cared so came from a place of that foster trust and the ability to [Music] impart that care to the people around them that were able to encourage and therefore ask the harder conversations um out of that um out of that basis um talked about those who helped us identify stretch goals and also then gave us the freedom to sort of embrace those and be proactive within our own strengths um to be able to attain the goals that maybe in and of ourselves we were not um willing to to try um so stretching and at the same time giving us the the freedom or the independence um as well it's inspiring i think that's when we do our best work right whenever we've got that confidence instilled in us and the freedom in the space and it does create that element of biomimicry and dr greenwood also has asked in the chat if you guys can share some of these things about teens that came up for you as well some of these teams that you've worked in that have embodied this any thoughts on that discuss the different types of leadership i mean there's leadership just as an organizational leader and then leadership in like a process like okay this person got the most compliments this month or this person generated the most rvus this quarter and we wanted to uh clarify that that was not the leader that we were talking about we're talking more about organizational leadership and you know we talked about maxwell's laws of leadership and about inspirational type leaders that motivate and create an environment for growth for teams and that help identify points of failure and make it more highly reliable so you grow your team and you grow the process so you don't have single points of failures you identify those and address those right away such a great point anything else come up for you all a lot of great comments coming up in the chat also yeah so please keep those chat those chat comments coming as we as we transition into to the next phase of this process um part of what we want to do remember this is about regenerativity so the ability to share those different ideas with each other that may be self-evident to you but may not have come up at all in another team so we want to talk a little bit more about how to break this into an even more practical practical way of leading and influencing and so when we talk about these principles of life affirming something that also comes to mind in a more practical way is how how we're intentionally curious and i heard some of these things come up when you guys were talking about different leaders that have embodied this for you but intentional curiosity or intentionally being curious consider what that might look like in a realm of instead of making the assumption or making a statement it's gosh i'd love to hear more about that it's a different perspective than i've heard before and then intentional career curiosity fosters life and your teens and how you interact with others we teach this concept of ever-changing and responsive and the way that that might look in your leadership is responsive leading so we've had many lessons over the last almost two years now with how we've had to respond to things that are outside of our control so often i've spoken with many of you in your leadership roles and how i've worked with you personally on how there are things that we can't control how do we then integrate and respond and integrate what's happening versus trying to control it because we know that we can't i also think about this concept of relational and collaborative that we discussed and it's leading beyond silos and i think sometimes we get caught up in these silos whether we intend to or not it's just the way our structure has somehow come forth but think about who else even outside of carillion btc or rock or some of these other groups how you might work with each other or collaborate with each other to do something completely different that you've never thought about before because that's where where we see this opportunity for regeneration and our leadership and in healthcare frankly so as jennifer said that what we do know is that the leadership that has gotten us to this point is not the leadership that's going to be able to lead us into the future that doesn't mean we need different leaders but that means that we as leaders can need to continue to evolve even in terms of how we look at how we approach our leadership and continue to stretch ourselves in in many ways so this idea of synergistic and diverse and not just the seeking out of contrary perspectives but actually embracing those actually encouraging deliberately encouraging contrary perspectives as a way to make sure that we're not falling into patterns that have become so ingrained that we're blind to them we don't even realize that we are doing those patterns because we just think that's the way things are and yet from diverse opinions certainly what we've seen during this the last 18 months is that we've been exposed to a lot of different opinions about many different things uh and and so the ability to as jennifer said begin to seek understanding of where those folks are coming from or where those perspectives are coming from as a leader in understanding how do i then integrate that in to a way that we can all move forward and not say the only way we're going to move forward is to leave some people behind this whole idea of cyclical and seasonal and how do we embrace that in the context of of go ahead and click the next one jennifer of deliberate paceships of really beginning to say how do we as leaders not say go go go it's 100 all the time which again in the old model was the way we did it and as soon as you were worn out we replaced you with someone else that's the assembly line way of thinking about our work well what happens now when we start to think about this and say there are times there are seasons there's there's a need for recovery there's a need for reflection and that's all going to be part of the necessity of our leadership going forward and that doesn't mean in the little pandemic that we still don't have to keep forcing some things and pushing them forward but even then the ability to step back and reflect and say we've been doing this this way for this amount of time but is this still the right way to do it conditions have changed we have new information how does that now change things or we have we have new new dynamics that are happening this whole idea of flows of energy and the ability to reflect and reframe as a way to make sure that what we're not doing is again getting stuck in an energetic cycle that's more now of a rut rather than a rhythm and how do we get back into that rhythm again in terms of the flows of energy and then finally this whole idea of living fields and building on themes part of what happens is looking for ways to say where are commonalities happening where are connections happening between these different these different whether it be within a group or between different groups and how do we make sure that we're both naming those and then building upon that because what that does is it allows diversity to come together into synergy and beginning to say together how can we move this forward so here's what we'd like you to do for the second round of discussion we're going to go back into your discussion groups for about 10 minutes and would like to have you sharing around these two ideas the first one which is which of these ideas that are on the slide right now speaks to you in the context of your present team culture which one is compelling to say wow either i think we're doing this really well right now and i want to i want to emphasize that or wow as i start to think about it we're not really paying any attention to this and and that's costing us and so here's how we may want to begin to emphasize that differently and then the second question which is the so what so what can we do about that how might we bring this these qualities more into our present system you know we're not we're not talking about two years from now we're talking about how can we start building upon these things right now so as you look at these seven themes how can we begin to build on those more so we're going to go ahead and put you back in your groups and have you share those two things and then we'll see you back in 10 minutes welcome back i'm actually going to take us out of share screen so that so we can see each other i'm so glad you all have cameras on and keep them on please if you don't mind in the larger discussion if you feel comfortable doing so it's good to see each other so so when you're in your groups which of those did you talk about that that speak most to you in this context well i told my group that i almost stopped thinking about anything else after you said something about silos because i could climb up on the sub box for a long time about that one that is a that can be a significant problem in our organization and i think it's something that we need to pay more attention to deliberately i mean it is difficult i hear from faculty all the time who have lots of different problems because of the way we're structured and i'm i'm frustrated about it because i don't really know how to answer all those those questions but it's a significant issue so after i saw that on the bubble i almost shut down after that i didn't think about anything else i'm glad you hung in there so how am i so i'll ask you the second question on that one because i wonder if others can relate it looks like you can how am i how about you bring that quality forward of reaching through breaking down even forgetting that there are silos pretending as if they're not because this hierarchical structure that happen in systems that's part of that mechanical way of thinking if we think if we think fluidly about organizational structure that that propagated silos to begin with they have no place in our world going forward so how do you how do you shift that i think one way to do that is to make a concerted effort that that's your priority i see it happening now at virginia tech where they have the beyond our boundaries of focus and also emphasizing um transdisciplinary team work um on projects for senior design projects for instance and i think that the same thing could be applied to medicine you can't you can't do a broad outreaching projects unless you do have that transdisciplinary or avoiding the silence type of philosophy right and maybe just focusing on the issue from multiple different perspectives so all those different perspectives the complementary perspectives can really contribute to solving the issue if you focus on the issue and not so much on the differences and all the problems that that the different silos bring about and then you have to work through those things as you go along i think as long as you're focused on solving the main problem it's good a great example of that is like the the sepsis team the co-creation team that was recently made i think that sounds exactly like what's happening they asked for volunteers from all disciplines and all um kind of structure so there's like like um institutional design as well as leadership and clinical clinicians um including like nurses and residents and everything else and kind of incorporating literally everyone that could have anything to do with patient care and i think we we do that more and more often now and it's really helpful that's awesome greta thank you i think we probably can't get rid of every part of this but i do think there are opportunities overcome it and i think teach is probably a great example of of an effort that has done that teach has been deliberately focused on building a community a community of educators and educational scholars across all of our various organizations and you could say well that's easy to do because everybody that's in there is interested in education and but but you wouldn't believe what had to be done in order just to create the infrastructure so that each could be successful so it's everything from computer stuff to i think we're so entrenched in our silo sometimes it doesn't even occur to us maybe jennifer you said this earlier it doesn't occur to us to think about it any differently we have to start by thinking about it differently if we're in an academic health center then we have to start thinking like one we can't think like a research institute and a hospital in a medical school in a university we have to figure out what that means to be an academic health center and start working together every way we can i think we need a committee on the destruction of silos as quickly as possible i volunteered dr greenwald to be the chair of it so i you know one of the things that that occurs to me when when i think about what you're saying about silos david is that the reality is that you know even short of a committee in the destruction of silos which sounds in one level fantastical um is the idea of saying okay well wait a minute i'm likely part of that present structure so even as a leader the way you begin to break down silos is by beginning to break down silos starting on an individual basis so you know for me to ask the question all right if silos are a problem let's say in my own department how am i contributing to that and how can i then as a leader begin to do that differently by reaching out beyond my own quote silo into other worlds and and you know the encouraging part of that is is that i see that happening i see that beginning to happen more and more certainly again i live on the clinical side more but certainly covet has has if nothing else reminded us that we are really interdependent in a way that we can't pretend otherwise and and while that's a painful lesson because of how it's happening it's certainly also an encouraging lesson and what i worry about even within the coveted world is that we know right now that some groups are being impacted more than others yeah some clinical groups are being impacted more than others and how do we stay connected and not feel like okay those in the emergency department and the icu or the yokovic units you know they're they're somehow separated from us rather than saying we're really still all in this together and we all have a part to play and how can we each play that part so i i love that david knows i'm phobic of committees so that um i'd have to have to go get therapy before i would be part of that but how about others i have to visualize it you know i i tend to visualize any any kind of a system like this as a as a spider web i mean it's a big spider web and if you pick up any one of those webs that's attached and you move it even if it's just a small amount it's going to change the shape of the whole web everything moves everything has now changed and it looks different and so you you have to really figure that that's essentially what happens i think oftentimes people don't consider the downstream effect of the kind of thing that they might choose to do and so teaching people to understand okay you know we're a big rube goldberg machine and if you you know roll the ball down and the lever presses it how else and who else is going to be affected by that process and you need to think that through as you're developing things so that you can make sure that you've hit every stakeholder and and you've addressed everybody that would be and should be involved that's an excellent analogy too doctor well i can't call your doctor right now or to see you but it's deirdre excellent analogy too when we think about from a biomimicry perspective that when we're making moves or changes that it's like lifting up a web and that things other things are going to be impacted by the movement of that web so who else do we want to bring into the folder who else should we collaborate with or to reflect or inflame in fact there was a comment here about this coming up with reflecting and reframing for you right now and how that's coming forward if you guys want to add the group that was talking about to add context i think that came from laura so mine was the um the idea of embracing contrary opinions which we talked about and that when you go across silos people are in their silos often because they share opinions and share ways of looking and we've been talking about you know if you think about hospital system science we've got people who so on the social science on the stats on the hardcore science on the actually doing of things all of those who have to look and value what each other does to get to the solution so we were talking about that in our group which is essentially the silos but from one of the other points that you made they're all so interconnected i guess that comes back to the webs yeah love that love that idea that even even as we think we're in silos and act like we're in silos we're really not um and so in some ways it's really coming to the realization that no matter how much we want to believe that that's false thinking in and of itself and that may become a nice reframe as well so i am i am conscious we are conscious of time and we promised sherry that we would stay on time and honor you all in terms of of your investment in our hour together our intention really was to begin a dialogue around this uh this is something within the institute of leadership effectiveness that we were talking about a lot right now which is not only how can we support our leaders you know in our present circumstances but how can we continue to allow them to grow and evolve beyond these circumstances uh knowing that that what needs to what health care needs to look like tomorrow is different than what healthcare needed to look like two years ago or did look like two years ago and that includes all of us so we hope that this is an installment in an ongoing conversation we would certainly welcome your feedback welcome your ideas uh welcome your contrary opinions uh we would welcome it all because that's how we're going to continue to grow and be able to support all of you in the context of the work that we're doing right now so so again sherry thank you for the work that you're doing to to bring these forums to to all of us so we can have a place to begin to have dialogue across all of these different components that we're a part of and we look forward to continuing that into the future.